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Boutelle KN, Manzano MA, Pasquale EK, Bernard RS, Strong DR, Rhee KE, Eichen DM, Engel S, Miller A, Peterson CB. Design of the FRESH-teen study: A randomized controlled trial evaluating an adapted emotion regulation weight loss program for adolescents with overweight or obesity and their parent. Contemp Clin Trials 2024; 145:107640. [PMID: 39079614 DOI: 10.1016/j.cct.2024.107640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/10/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Abstract
Overweight and obesity affect >40% of adolescents. Family-based behavioral treatment (FBT) is the most efficacious behavioral treatment for weight management among youth and consists of nutrition and physical activity education, behavior change skills, and parent skills training. However, the efficacy of FBT decreases for youth as they get older. Increased emotional lability and limited emotion regulation skills may contribute to the reduced efficacy of FBT for adolescents. To date, there are no treatments for overweight or obesity specifically adapted for the needs of adolescents. We developed a treatment that integrates components from Dialectical Behavior Therapy and Emotion Focused Therapy with FBT (FBT+ER or FBT-ER) to address the specific needs of adolescents. The current study randomized 166 adolescents (BMI = 32.8; 14.3 years; 57% female; 32% Hispanic, 50% Non-Hispanic White, 18% Non-Hispanic and Non-White) and one of their parents (BMI = 32.9; 45.3 years; 85% female; 27% Hispanic, 57% Non-Hispanic White, 16% Non-Hispanic and Non-White) to 6 months of either standard FBT or FBT+ at 2 sites. Assessments were conducted at baseline, mid-treatment (month 3), post-treatment (month 6), 6-month follow-up (month 12) and 12-month follow-up (month 18). Primary outcomes are adolescent weight (BMIz/%BMIp95), emotion regulation skills, and emotional eating behaviors. Given the public health concern of adolescent obesity, FBT+ could prove extremely useful to provide more targeted and effective intervention for adolescents with overweight or obesity. CLINICAL TRIALS: # NCT03674944.
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Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA.
| | - Michael A Manzano
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA
| | - Ellen K Pasquale
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA
| | - Rebecca S Bernard
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - Scott Engel
- Sanford Research, 120 S. 8(th) St., Fargo, ND 58103, USA
| | - Alec Miller
- Department of Psychiatry, Albert Einstein College of Medicine, 1 North Broadway Room: 704, White Plains, NY 10601, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
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2
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Yardley HL, McTiernan EF, Lemanek KL. A Narrative Review of Depression and Suicide in Adolescent Females to Guide Assessment and Treatment Recommendations. J Pediatr Adolesc Gynecol 2024; 37:460-464. [PMID: 38703944 DOI: 10.1016/j.jpag.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
STUDY OBJECTIVE Suicide is a leading cause of death for adolescents. Medical professionals are increasingly being asked to screen for depressive symptoms and suicidal ideation with little training. The purpose of this paper is to review factors related to suicidal thoughts and actions, assessment of symptoms, and initial suggestions for treatment for medical providers. METHODS A literature review of risk and resilience factors, assessment measures, and treatment options for depression and suicidal ideation and behavior in adolescent females was conducted. RESULTS Given the higher risk of suicidal thoughts and depressive symptoms in adolescent females, accurate and thorough assessment of symptoms is recommended. CONCLUSION Medical providers should be aware of symptoms related to depression and suicidal ideation in order to provide more effective assessments. Recommendations for brief assessment measures that can be used in the clinic and possible first line treatments are provided.
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3
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Ip JWY, McMain SF, Chapman AL, Kuo JR. The role of emotion dysregulation and interpersonal dysfunction in nonsuicidal self-injury during dialectical behavior therapy for borderline personality disorder. Behav Res Ther 2024; 180:104594. [PMID: 38945041 DOI: 10.1016/j.brat.2024.104594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 07/02/2024]
Abstract
Dialectical Behaviour Therapy (DBT) is an evidence-based treatment for borderline personality disorder (BPD), with findings demonstrating improvements in various BPD features and related behaviours, such as nonsuicidal self-injury (NSSI). Theory and research suggest that reductions in emotion dysregulation and interpersonal dysfunction could account for at least some of the reduction in NSSI observed during the course of DBT. The current research investigated: 1) the trajectory of changes in emotion dysregulation, interpersonal dysfunction, and NSSI over the course of DBT, and 2) whether changes in emotion dysregulation mediate the relationship between changes in interpersonal dysfunction and changes in NSSI over treatment. One hundred and twenty individuals with BPD enrolled in a multi-site randomized-clinical trial were assessed at five timepoints over 12 months of standard DBT. Results indicated that interpersonal dysfunction and NSSI decreased over the course of DBT. Emotion dysregulation decreased in a quadratic manner such that most of the gains in emotion dysregulation occurred in earlier phases of DBT. Although changes in interpersonal dysfunction predicted changes in emotion dysregulation, changes in emotion dysregulation did not mediate the relationship between changes in interpersonal dysfunction and changes in NSSI.
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Affiliation(s)
- Jennifer W Y Ip
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada.
| | - Shelley F McMain
- Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | | | - Janice R Kuo
- Department of Psychology, Palo Alto University, California, USA
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4
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Bruton AM, Wesemann DG, Machingo TA, Majak G, Johnstone JM, Marshall RD. Ketamine for mood disorders, anxiety, and suicidality in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02458-y. [PMID: 38750191 DOI: 10.1007/s00787-024-02458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/29/2024] [Indexed: 07/13/2024]
Abstract
Mood disorders, anxiety, and suicidality in youth are increasing and rapid-acting treatments are urgently needed. One potential is ketamine or its enantiomer esketamine, which was FDA approved in 2019 to treat major depressive disorder with suicidality in adults. This systematic review evaluated the evidence for the clinical use of ketamine to treat mood disorders, anxiety, and suicidality in youth. The PRISMA guidelines were used, and a protocol registered prospectively ( https://osf.io/9ucsg/ ). The literature search included Pubmed/MEDLINE, Ovid/MEDLINE, Scopus, CINAHL, PsychInfo, and Google Scholar. Trial registries and preprint servers were searched, and authors contacted for clarification. Studies reported on the clinical use of ketamine to treat anxiety, depression, bipolar disorder, or suicidality in youth ≤19 years old and assessed symptoms before and after ketamine use. Study screening and data extraction were conducted independently by 2-4 authors. Safety, tolerability, and efficacy data were collected. The Cochrane Risk of Bias guidelines assessed the quality of the evidence. Twenty-two published reports based on 16 studies were identified: 7 case studies, 6 observational studies, 3 randomized trials, and 6 secondary data analyses. Studies reported immediate improvements in depression, anxiety, and suicidality. Improvements were maintained for weeks-months following treatment. Ketamine was well-tolerated with the most common side effects being dizziness, nausea, and mild dissociation. Transient hemodynamic changes were reported, all of which resolved quickly and did not require medical intervention. Initial evidence suggests ketamine is safe and may be effective for mood disorders, anxiety, and suicidality in youth. Further randomized trials are warranted.
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Affiliation(s)
| | | | | | - Gop Majak
- University of Lethbridge, Lethbridge, Canada
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5
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Conroy K, Kehrer SM, Georgiadis C, Hare M, Ringle VM, Shaw AM. Learning from Adolescents and Caregivers to Enhance Acceptability and Engagement Within Virtual Dialectical Behavior Therapy for Adolescents Skills Groups: A Qualitative Study. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01641-7. [PMID: 38183575 DOI: 10.1007/s10578-023-01641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/08/2024]
Abstract
Despite the significant increase in adolescent mental health challenges in recent years, structural barriers continue to limit access to and engagement in mental health services. As such, opportunities to learn directly from adolescents and their families on how to best structure and deliver services are paramount. The current study assumes a multi-informant approach and reports on adolescents' and caregivers' (N = 33) experiences in an adapted telehealth/hybrid Dialectical Behavior Therapy for Adolescents (DBT-A) program. Focus groups were conducted across two cohorts of families who participated in DBT-A skills groups, to collect family-centered data on the acceptability of program modifications, engagement in the adapted telehealth/hybrid DBT-A, and recommendations for improvement. Participants were predominately Latine White and were from a broad range of socioeconomic backgrounds. Additionally, 45.5% of the adolescents identified as LGBTQ + . Focus group findings emphasized how the telehealth platform was both convenient and disengaging, and how in-person sessions offered improved group connection and content engagement. Participants underscored the importance of balancing multi-family group sessions with adolescent- and caregiver-only group sessions in the program, and adolescents emphasized a need for the DBT-A program to better center adolescents' unique experiences and voices throughout sessions. Both adolescents and caregivers suggested modifications to synthesize the content and improve generalizability of the DBT-A skills to their real lives. Overall, these findings add to a new and evolving branch of DBT-A qualitative inquiry, as well as the growing body of work that recommends incorporating the voices of people with lived experiences into the development and modification of psychological services.
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Affiliation(s)
- Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Sabrina M Kehrer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Christopher Georgiadis
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
- The Warren Alpert Medical School, Department of Psychiatry, Brown University, Providence, RI, USA
| | - Megan Hare
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Vanesa Mora Ringle
- Counseling Psychology Program, Department of Education and Human Services, Lehigh University, Bethlehem, PA, USA
| | - Ashley M Shaw
- School of Social and Behavioral Sciences, University of New England, Biddeford, ME, USA
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6
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Tseng YC, Ditchman N. Non-suicidal self-injury in a college sample: Intrapersonal and family factors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37167593 DOI: 10.1080/07448481.2023.2209206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Objective: Adolescents and young adults are at risk for non-suicidal self-injury (NSSI) and suicidal behavior. This study examined intrapersonal (depressive symptoms, self-criticism) and family (perceived family functioning, parenting style, parental attachment) factors associated with reported history of NSSI in a college sample. Method: Participants included 111 undergraduate students (Mage = 20.2) from a private, nonprofit university. Data were collected via online survey. Hierarchical logistic regression analysis was conducted. Results: The final model was statically significant, Nagelkerke R2 = .40, suggesting a robust association between the predictors and history of NSSI. Self-criticism and unhealthy family functioning were significant predictors of NSSI behaviors after controlling for study variables and demographic characteristics. Reported history of engaging in NSSI was positively correlated with parent alienation, unhealthy family functioning, self-criticizing behaviors, and depressive symptoms. Conclusion: College mental health providers should be familiar with risk factors of NSSI as well as strategies to address self-criticism.
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Affiliation(s)
- Yen Chun Tseng
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Nicole Ditchman
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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7
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Ceccolini CJ, Friedman-Yakoobian MS, Yen S, West ML. Safety Planning in Context: A Case Study Integrating DBT Techniques and ACT for Overlapping Suicide and Psychosis Risk. Clin Case Stud 2022. [DOI: 10.1177/15346501221139916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Suicide risk is markedly higher for clients at clinical high risk for psychosis (CHR-p) compared to the general population. Dialectical behavior therapy (DBT) has a strong evidence base supporting its utility for managing suicide risk. Meanwhile, acceptance and commitment therapy (ACT) has been shown to effectively treat individuals with psychosis symptoms, as well as comorbid anxiety and mood disorders in CHR-p clients. Despite the robust evidence for each of these modalities in addressing concerns around suicidality and psychosis risk independently, there is a paucity of literature on how to support clients experiencing co-occurring suicide and psychosis risk. Such overlapping risk is often central to presenting concerns in CHR-p clients. Our manuscript presents a case example of an integrated DBT-ACT approach to managing risk surrounding both suicide and psychosis symptoms in an outpatient setting. We highlight how an integrated approach may help outpatient providers to implement and modify effective treatment that promotes continued outpatient care focused on goals beyond immediate risk management of both suicide and emerging psychosis. We provide specific examples of DBT techniques and ACT interventions used by a supervised doctoral-level student clinician in treatment with a CHR-p client and discuss implications for future clinical research.
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Affiliation(s)
| | | | - Shirley Yen
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Michelle L. West
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
- University of Colorado – Anschutz Medical Campus, Aurora, CO, USA
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8
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Pearce H, Smoliak O, Lewis SP. Individuals’ accounts and explanations of continued engagement in non-suicidal self-injury: a qualitative study. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2108762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Heather Pearce
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Olga Smoliak
- Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Stephen P. Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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9
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Lakeman R, King P, Hurley J, Tranter R, Leggett A, Campbell K, Herrera C. Towards online delivery of Dialectical Behaviour Therapy: A scoping review. Int J Ment Health Nurs 2022; 31:843-856. [PMID: 35048482 PMCID: PMC9305106 DOI: 10.1111/inm.12976] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/24/2021] [Accepted: 01/03/2022] [Indexed: 12/31/2022]
Abstract
Dialectical Behaviour Therapy (DBT) programmes are often the only available treatment for people diagnosed with borderline personality disorder and were rapidly converted to online delivery during the COVID-19 pandemic. Limited research exists surrounding how the major elements of DBT are delivered in an online environment. This scoping review considered the operationalization of online delivery of DBT and its effectiveness. EBSCO host databases were searched using free text. Of 127 papers, 11 studies from 2010 to 2021 investigating online DBT for any clinical population were included in the review. A narrative synthesis of papers selected was undertaken. Seven articles reported results from five clinical trials (n = 437). Most adaptations mirrored face-to-face programmes although there was considerable variation in how therapy was facilitated. Attendance was reported to be greater online with comparable clinical improvements to face-to-face for those who remained in therapy. Additional challenges included managing risk, therapist preparedness and technology difficulties. Online delivery of DBT programmes is feasible and may be more accessible, acceptable and as safe and effective as face-to-face delivery. However, mirroring face to face delivery in an online environment may not be the most effective and efficient way to adapt DBT to online provision. Research is needed to identify areas which require further adaptation.
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Affiliation(s)
- Richard Lakeman
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Peter King
- Australian DBT Institute, Southport, Queensland, Australia
| | - John Hurley
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Richard Tranter
- Mid North Coast Local Health District, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Andrew Leggett
- Mid North Coast Local Health District, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Katrina Campbell
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
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10
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Turan B, Akıncı MA. A clinical follow-up study of dialectical behavior therapy skills groups among female adolescents diagnosed with depressive disorder. Clin Child Psychol Psychiatry 2022; 27:701-715. [PMID: 35446715 DOI: 10.1177/13591045221088710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our aim was to evaluate longitudinal data for adolescents who were treated with Dialectical Behavior therapy (DBT) skills groups having been previously diagnosed with depressive disorder. Intervention with an observational cross-sectional design was implemented to evaluate the treatment outcome of a 10-week DBT skills groups with female adolescents with depression. After the patients were identified for enrollment, parents and adolescents were evaluated with psychometric measurements pre-, post-intervention, and at one-year follow-up. Repeated measures analysis was undertaken with the Child Depression Inventory (CDI), Pediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaire (SDQ) for participants. Statistical significance was detected for self-report CDI scores and both self-report and parent SDQ and PedsQL scores. This study is the first DBT intervention in Turkish children, shows that a group DBT skills groups training can be adapted and put into practice successfully with depressed Turkish adolescents.
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Affiliation(s)
- Bahadır Turan
- Turkish Ministry of Health, Agrı State Hospital, Child and Adolescent Psychiatry Unit, Agri, Turkey
| | - Mehmet Akif Akıncı
- Turkish Ministry of Health, Dr. Ali Kemal Belviranlı Maternity and Children Hospital, Child and Adolescent Psychiatry Unit, Konya, Turkey
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11
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Sex and gender in treatment response to dialectical behaviour therapy: current knowledge, gaps, and future directions. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Borderline personality disorder (BPD) is a mental health condition characterized by emotion dysregulation, interpersonal impairment, and high suicidality. Dialectical behaviour therapy (DBT) is the most widely studied psychotherapeutic treatment for BPD. To date, the vast majority of DBT research has focused on cisgender women, with a notable lack of systematic investigation of sex and/or gender differences in treatment response. In order to encourage effective, equitable treatment of BPD, further investigation into treatment targets in this population is critical. Here, we employed a systematic strategy to delineate gaps in the DBT literature pertaining to sex and gender differences and propose directions for future research. Findings demonstrate a significant discrepancy in measurement of sex and gender, particularly among gender-diverse individuals. Exploring DBT treatment response across the full spectrum of genders will facilitate the provision of more tailored, impactful care to all individuals who suffer from BPD.
Key learning aims
(1)
To date, DBT treatment literature has focused almost exclusively on cisgender women, with only two of 253 DBT studies in current literature accounting for transgender and gender diverse (TGD) individuals.
(2)
Recognize how gender minority stress may impact the prevalence of BPD among TGD individuals.
(3)
Learn how future research initiatives can be employed to rectify this gap in the DBT literature.
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12
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Lenz AS, Conte GD, Douglas C, Crenshaw A, Dobbs C, Stogner E, Williford V. A pre‐experimental evaluation of treatment gains associated with a DBT‐A partial hospitalization program. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Stephen Lenz
- Texas A&M University‐San Antonio, One University Way San Antonio Texas 78224 USA
| | - Garry Del Conte
- Daybreak Treatment Center 2262 South Germantown Road Germantown Tennessee 38138 USA
| | - Cameron Douglas
- The University of Mississippi 101 Guyton Hall University Mississippi 38677 USA
| | - Ayanna Crenshaw
- The University of Mississippi 101 Guyton Hall University Mississippi 38677 USA
| | - Christin Dobbs
- The University of Mississippi 101 Guyton Hall University Mississippi 38677 USA
| | - Emily Stogner
- The University of Mississippi 101 Guyton Hall University Mississippi 38677 USA
| | - Victoria Williford
- The University of Mississippi 101 Guyton Hall University Mississippi 38677 USA
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13
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Ramsey WA, Berlin KS, Del Conte G, Lightsey OR, Schimmel-Bristow A, Marks LR, Strohmer DC. Targeting self-criticism in the treatment of nonsuicidal self-injury in dialectical behavior therapy for adolescents: a randomized clinical trial. Child Adolesc Ment Health 2021; 26:320-330. [PMID: 33608976 DOI: 10.1111/camh.12452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Benefits and Barriers Model proposes both benefits and barriers associated with nonsuicidal self-injury (NSSI) and that a negative association with the self plays a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added benefit of targeting self-criticism in the treatment of NSSI. METHODS Sample included 40 participants (30 females; Mage = 14.92) enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to decrease self-criticism. RESULTS There was no evidence of an indirect effect of targeting self-criticism upon NSSI at post-treatment via post-treatment self-criticism (b = -0.98, p = .543); however, there was evidence of a significant interaction between treatment condition and self-criticism at pretreatment in the prediction of NSSI at post-treatment (b = 0.33, p = .030). Analyses of simple slopes indicated the conditional direct effect of targeting self-criticism varied as a function of patient's level of self-criticism at the onset of treatment, such that individuals -1 SD below the mean (b = -5.76, p = .037) and at average pretreatment levels of self-criticism (b = -4.09, p = .042), but not + 1 SD above the mean (b = -2.42, p = .056), experienced fewer incidents of NSSI at post-treatment. CONCLUSIONS The results of this investigation support the added benefit of targeting self-criticism in the treatment of NSSI for adolescents.
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Affiliation(s)
- William A Ramsey
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | | | - Garry Del Conte
- Department of Psychology, The University of Memphis, Memphis, TN, USA.,Daybreak Treatment Center, Germantown, TN, USA
| | - Owen R Lightsey
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Allison Schimmel-Bristow
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Laura R Marks
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Douglas C Strohmer
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
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14
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West ML, Guest RM, Carmel A. Comorbid early psychosis and borderline personality disorder: Conceptualizing clinical overlap, etiology, and treatment. Personal Ment Health 2021; 15:208-222. [PMID: 33955194 DOI: 10.1002/pmh.1509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Despite substantial efforts aimed at the detection and intervention for early symptoms of mental illness, there is relatively limited research on the clinical overlap between borderline personality disorder (BPD) and early psychosis, for example, clinical high risk (CHR) for psychosis, in young people. We present a narrative review of the clinical overlap between BPD and psychosis spectrum symptoms. Both conditions have unstable temporal course, and both are marked by functional impairment, increased suicide risk, and higher rates of psychiatric inpatient services. We then review evidence-based treatments for psychosis and BPD, emphasizing treatments for early presentations of these symptoms and initial research considering treatments for the overlap. Psychotherapies with the strongest empirical support include cognitive behavioral models, with BPD showing limited response to adjunctive pharmacotherapy. We end by discussing specific recommendations for future research, including longitudinal studies to determine the predictors of the course of illness and the development of treatments to target comorbid BPD and CHR symptoms.
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Affiliation(s)
- Michelle L West
- CEDAR Clinic and Research Program, Massachusetts Mental Health Center, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, University of Colorado School of Medicine (CUSOM), Aurora, Colorado, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Adam Carmel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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15
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Zapolski T, Whitener M, Khazvand S, Crichlow Q, Revilla R, Salgado EF, Aalsma M, Cyders M, Salyers M, Wu W. Implementation of a Brief Dialectical Behavioral Therapy (DBT) Skills Group in High Schools for At-Risk Youth: Protocol for a Mixed-Methods Study (Preprint). JMIR Res Protoc 2021; 11:e32490. [PMID: 35551054 PMCID: PMC9136647 DOI: 10.2196/32490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescence is a developmental period marked by engagement in risk-taking behaviors, especially among impulsive or emotionally dysregulated youth. Thus, interventions that teach skills to reduce the risk of negative outcomes associated with emotional dysregulation are required. Social and emotional learning (SEL) programs have been developed to address both adolescent emotional dysregulation and risk-taking behaviors; however, current programs have mostly been implemented among younger youth and are used as a tier 1 universal intervention rather than a targeted tier 2 intervention for youth identified with emotional regulation difficulties. Objective This study aimed to address the need for SEL programming that can be delivered in schools, particularly for older youth who have difficulties with emotional or behavioral dysregulation, to reduce the risk of health-risk behaviors among this population. Methods Here, we outline the implementation of an SEL intervention titled Going 4 Goals, a 9-session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program delivered to at-risk high school students in a school setting. The primary objectives of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and after the intervention and follow-ups at 1, 3, and 6 months compared with a control group of youth participating in the school’s health curriculum at the same time points. Qualitative interviews will also be conducted with intervention participants and school staff to examine acceptability and facilitators of and barriers to the intervention. Results A total of 171 participants across 13 groups had been enrolled in the intervention, with data collection ending December 2021. Data analysis will begin in the spring of 2022, with expected results to be published in the spring of 2023. Conclusions This paper describes the protocol of the 9-session school-based adaptation of the DBT-A intervention and discusses the strengths and limitations of the study and future directions. International Registered Report Identifier (IRRID) DERR1-10.2196/32490
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Affiliation(s)
- Tamika Zapolski
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - MacKenzie Whitener
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Shirin Khazvand
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | | | | | - Eduardo F Salgado
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Matthew Aalsma
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Melissa Cyders
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Michelle Salyers
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Wei Wu
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Jones J, Blinkhorn A, McQueen M, Hewett L, Mills-Rogers MJ, Hall L, Althagafi L, Hudson C, Gierc M, Wright K, Goettl H, Keogh-Lim D, Rischke-Peddle A, Ayub M. The adaptation and feasibility of dialectical behaviour therapy for adults with intellectual developmental disabilities and transdiagnoses: A pilot community-based randomized controlled trial. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:805-817. [PMID: 33599087 DOI: 10.1111/jar.12860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/07/2021] [Accepted: 01/16/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Preliminary evidence suggests dialectical behaviour therapy (DBT) may be beneficial for persons with intellectual disabilities. This pilot randomized controlled trial aimed to determine the feasibility of adapted DBT for adults with intellectual disabilities and co-morbid psychiatric disorders in the community. METHODS An adapted DBT programme (aDBT-ID) was delivered to adults with mild-to-moderate intellectual disability (n = 20) and their caregivers (n = 20). A single-blind, mixed-methods design was employed with treatment (n = 10) and control (n = 10). In addition to feasibility, pre-post-measures of emotional regulation, anger and mental health were taken from clients and caregivers. RESULTS Results suggest it was feasible and beneficial to deliver adapted DBT in the community. Qualitative findings found both participants and caregivers were satisfied with the treatment delivery. No differences between conditions were found. CONCLUSION This pilot study highlights the feasibility of adapted DBT for individuals with intellectual disabilities and the practicalities of delivering community-based inclusive research.
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Affiliation(s)
- Jessica Jones
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | | | - Meg McQueen
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Laura Hewett
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
| | - Mary-Jane Mills-Rogers
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
| | - Layla Hall
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Lujain Althagafi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Chloe Hudson
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Madelaine Gierc
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Kristyn Wright
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Hannah Goettl
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Daniel Keogh-Lim
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | | | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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Holland M, Hawks J, Morelli LC, Khan Z. Risk Assessment and Crisis Intervention for Youth in a Time of Telehealth. ACTA ACUST UNITED AC 2021; 25:12-26. [PMID: 33425481 PMCID: PMC7786878 DOI: 10.1007/s40688-020-00341-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
For the last decade, there has been growing concern regarding the rising rates of youth engagement in self-injury and suicide. The worldwide outbreak of the coronavirus disease 2019 (COVID-19) has elevated these concerns due to increased risk factors pertaining to social, family, economic, and health stressors, in addition to changes to typical routines and support systems. Unfortunately, there are many barriers to at-risk youth being able to access evidence-based mental health services including cost, lack of trained providers, transportation issues, and physical distancing due to the pandemic. Providing school-based prevention and intervention programs that promote social, emotional, and behavioral well-being helps to address many of these barriers. This article highlights important considerations to providing these services in a school-based telehealth modality. Symptom clusters that put youth at risk of harm to self are described. Best practice therapeutic modalities that can be disseminated in a school-based telehealth modality, such as cognitive behavior therapy, dialectical behavior therapy, and mindfulness-based approaches, are reviewed. Although there is growing empirical literature for these school-based prevention and intervention approaches, additional research is needed to determine how to best support at-risk youth remotely.
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Affiliation(s)
- Melissa Holland
- California State University, Sacramento, Sacramento, CA USA
- Sacramento, USA
| | - Jessica Hawks
- School of Medicine, University of Colorado, Boulder, CO USA
| | | | - Zainab Khan
- California State University, Sacramento, Sacramento, CA USA
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18
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Muller DL, Buser TJ, Farag MS, Buser JK. Experiences of Unintentionally Severe Harm During Nonsuicidal Self‐Injury Among College Students. JOURNAL OF COLLEGE COUNSELING 2020. [DOI: 10.1002/jocc.12168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Daniella L. Muller
- Department of Graduate Education, Leadership, and Counseling Rider University
| | - Trevor J. Buser
- Graduate School of Counseling and Psychology Naropa University
| | - Mena S. Farag
- Department of Graduate Education, Leadership, and Counseling Rider University
| | - Juleen K. Buser
- Department of Graduate Education, Leadership, and Counseling Rider University
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Zalewski M, Maliken AC, Lengua LJ, Martin CG, Roos LE, Everett Y. Integrating dialectical behavior therapy with child and parent training interventions: A narrative and theoretical review. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020. [DOI: 10.1111/cpsp.12363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Suicide is the second leading cause of death among adolescents worldwide, yet adequate mental health services for children and adolescents are lacking across the globe. Likewise, youth who engage in non-suicidal self-injury (NSSI) are at heightened risk for suicide, but few pediatric settings have established protocols for screening and responding to youth who engage in NSSI and/or endorse thoughts of suicide. In this article, we highlight similarities and differences of managing suicide and NSSI across cultures, including persisting stigma associated with youth at risk for self-harm. We summarize current guidelines for screening youth at risk for suicide and NSSI across services, consider the use of online and telehealth services, and offer recommendations for a multidisciplinary approach to treating youth who engage in self-harming behaviors as well as how healthcare professionals can communicate with each other using common, non-stigmatizing language. We conclude with a discussion of future policy recommendations and areas for research.
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Affiliation(s)
- Nicholas J Westers
- Department of Psychiatry, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, USA
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria
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Abstract
Self-injury is a mental health-related behavior people engage in to feel pain because they feel numb, to experience physical pain to ease their psychological pain, or to experience an emotional release. Self-injury is more common in patients with other co-occurring anxiety or mood disorders. An addictive component to self-injury has been identified related to an increase in dopamine levels from the self-injury, which then disrupts normal dopamine production similar to substance use disorders. Instruments are available to help identify patients who self-injure along with questions that should be asked in the course of a mental health assessment and physical examination. Patients with self-injury should be treated for any underlying mental health disorder as well as for self-injury, which includes therapy strategies and medications. Nurses can play a vital role in identifying and treating this disorder, which carries risk factors including infection, accidental death, and a higher risk of suicide. [Journal of Psychosocial Nursing and Mental Health Services, 58(6), 13-16.].
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22
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Pardo ES, Rivas AF, Barnier PO, Mirabent MB, Lizeaga IK, Cosgaya AD, Alcántara AC, González EV, Aguirre B, Torres MAG. A qualitative research of adolescents with behavioral problems about their experience in a dialectical behavior therapy skills training group. BMC Psychiatry 2020; 20:245. [PMID: 32429886 PMCID: PMC7238612 DOI: 10.1186/s12888-020-02649-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/04/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Several quantitative studies support the effectiveness of the Dialectical Behavior Therapy (DBT) psychosocial skills training group component for adolescents with impulse-control disorder and/or emotional dysregulation. However, qualitative research to assess this psychotherapeutic tool in the adolescent population is sparse. This study aims to examine the subjective experience of adolescents with behavioral issues who have completed DBT skills training group, as well as using this experience to extract hypotheses regarding its usefulness which can then be verified at a later time by means of quantitative instruments. METHODS We developed a qualitative study by using focus groups with adolescents (N = 20) whose diagnosis includes symptoms such as behavior disorder, impulse-control disorder and/or emotional dysregulation, and good informants, who have completed DBT skills training. Three focus groups were created. RESULTS The subjective experience of adolescents who have completed a DBT skills training group is collected in four main categories: experience of illness, motivation for therapy, experience of therapy and results of the therapy. CONCLUSIONS Adolescents with behavioral problems assess their participation in the DBT skills training group positively, even recommending its usefulness to healthy population. Beyond learning skills, they emphasize the intrapsychic changes (as improvement in reflective activity) that they objectify after the group experience.
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Affiliation(s)
- Eva Sesma Pardo
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain.
| | - Aránzazu Fernández Rivas
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
- Department of Neuroscience, University of the Basque Country, Bilbao, Spain
| | - Pablo Orgaz Barnier
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
| | - Marina Beá Mirabent
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
| | - Iñaki Kerexeta Lizeaga
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
| | - Aída Díaz Cosgaya
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
| | - Ana Catalán Alcántara
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
- Department of Neuroscience, University of the Basque Country, Bilbao, Spain
| | | | - Blaise Aguirre
- East Residential. McLean Hospital, Belmont, USA
- Assistant Professor of Psychiatry. Harvard Medical School, Boston, USA
| | - Miguel Angel González Torres
- Psychiatry Service, Basurto University Hospital, Avda Montevideo, 18 48013, Bilbao, Spain
- Department of Neuroscience, University of the Basque Country, Bilbao, Spain
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Implementing Dialectical Behavior Therapy Skills Training With at-Risk Male Youth in a Military-Style Residential Program. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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24
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Eidet LM, Dahlgren A, Elvsåshagen M. Unwanted effects of treatments for depression in children and adolescents: a mapping of systematic reviews. BMJ Open 2020; 10:e034532. [PMID: 32217564 PMCID: PMC7170590 DOI: 10.1136/bmjopen-2019-034532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/10/2019] [Accepted: 01/28/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To describe the results of a mapping review exploring the coverage of unwanted treatment effects in systematic reviews of the effects of various treatments for moderate to severe depression in children and adolescents. SETTING Any context or service providing treatment for depression, including interventions delivered in local communities and school settings, as well as services provided in primary or specialist care. PARTICIPANTS Children and young people with moderate to severe depression (<18 years). INTERVENTIONS Systematic reviews published in 2011 or later comparing the effects of any treatment for children and adolescents with moderate to severe depression meeting the Database of Abstracts of Reviews of Effects criteria. The systematic search was performed in April 2018 and updated in December 2018. PRIMARY OUTCOMES Any unwanted effects of treatments as defined in the systematic review. RESULTS We included 10 systematic reviews covering 19 treatment comparisons. Unwanted effects were assessed for seven of 19. Three comparisons were evaluations of pharmaceutical interventions or combination therapy, reporting effects on 'suicidal ideation' and 'suicide risk'. Two included therapy, reporting 'self-harm', and 'suicidal ideation', and two comparisons included transcranial magnetic stimulation and electroconvulsive treatment. Unwanted effects evaluated for these treatments were mostly symptoms of physical discomfort such as headache or cramps. For the remaining treatment comparisons evaluating psychological and psychosocial therapies, unwanted effects were not evaluated or found. A limitation of overviews of systematic reviews such as this mapping study is that data extraction is done based on the reporting of results by the review authors and not on the primary studies. CONCLUSION The unwanted effects of widely used treatments for children and young people with depression is unknown. This is a major barrier for evidence informed decision making about treatment choices for children and young people. We suggest that unwanted effects should be a reporting standard in all protocols describing evaluations of treatments, including primary studies as well as systematic reviews.
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Affiliation(s)
- Lise Mette Eidet
- Section for Evidence Review, Research Support and Communication, RBUP, Oslo, Norway
| | - Astrid Dahlgren
- Section for Evidence Review, Research Support and Communication, RBUP, Oslo, Norway
| | - Mari Elvsåshagen
- Section for Evidence Review, Research Support and Communication, RBUP, Oslo, Norway
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25
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Reilly EE, Orloff NC, Luo T, Berner LA, Brown TA, Claudat K, Kaye WH, Anderson LK. Dialectical behavioral therapy for the treatment of adolescent eating disorders: a review of existing work and proposed future directions. Eat Disord 2020; 28:122-141. [PMID: 32301680 DOI: 10.1080/10640266.2020.1743098] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Over the past several decades, Dialectical Behavior Therapy (DBT) has been adapted for a range of presenting problems related to emotion dysregulation. Considerable enthusiasm exists regarding the use of DBT for treating eating disorders; however, to date, there have been no reviews summarizing empirical efforts to adapt DBT for eating disorders in youth. Accordingly, in the present narrative review, we provide a comprehensive summary of existing work testing DBT for adolescent eating disorders. First, we briefly review existing work applying DBT to eating disorders in adults and general adolescent samples. We then review research focused specifically on the use of DBT for adolescent eating disorders, including both those studies applying DBT as the primary treatment and investigations of DBT as an adjunctive treatment. Overall, initial results for DBT-based approaches are promising. However, rigorous empirical work testing DBT for treating adolescent eating disorders remains limited; the majority of existing research is comprised of case series and small-scale studies. Therefore, we close with specific recommendations for future research testing this approach.
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Affiliation(s)
- Erin E Reilly
- Department of Psychiatry, University of California, San Diego, CA, USA.,Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Natalia C Orloff
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Tana Luo
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Laura A Berner
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Kimberly Claudat
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Leslie K Anderson
- Department of Psychiatry, University of California, San Diego, CA, USA
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Westlund Schreiner M, Klimes-Dougan B, Parenteau A, Hill D, Cullen KR. A Framework for Identifying Neurobiologically Based Intervention Targets for NSSI. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00188-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Hunnicutt Hollenbaugh KM, Lenz AS. Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents. JOURNAL OF COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1002/jcad.12186] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - A. Stephen Lenz
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
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Abstract
A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances emotion regulation skills to reduce problem behaviors among adolescent populations; however, limited research has been conducted implementing the program within school settings. The current study was a 9-week DBT skills group conducted among 80 middle school youth, with pre-posttest data among 53 students. Findings indicated feasibility to implement the program in schools and preliminary evidence of efficacy in decreasing youth's likelihood to engage in risky, particularly among youth high on an emotion-based impulsivity trait. Brief DBT skills group may be an effective program to be utilized by school nurses and health-care teams to reduce health risk behaviors among school-aged youth.
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Affiliation(s)
- Tamika C B Zapolski
- 1 Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Gregory T Smith
- 2 Department of Psychology, University of Kentucky, Lexington, KY, USA
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