St. Patrick's University Hospital, Dublin, Ireland.
Behav Cogn Psychother. 2014 Mar;42(2):156-65. doi: 10.1017/S1352465812001002. Epub 2012 Dec 7.
Dialectical Behaviour Therapy (DBT) is an evidence-based treatment effective in reducing deliberate self-harm. However, DBT is resource and time intensive, and few services are able to sustain a programme faithful to all aspects. Thus, modified or adapted versions of DBT have been developed, particularly for delivery in inpatient hospital settings.
This study presents a description of the "Living Through Distress" (LTD) Group, which is based on the group skills training component of DBT.
Participants (n = 114) were patients of a psychiatric hospital who attended the LTD group. The main inclusion criterion for the LTD group was a history of deliberate self-harm. The outcome measures were frequency of incidents of deliberate self-harm, levels of distress tolerance, and mean numbers of bed days per year.
Upon completion of the group, there were significant reductions in participants' reports of deliberate self-harm and significant increases in their distress tolerance levels, which were maintained at 3-month follow-up. There was also a reduction in participants' mean number of inpatient days at 1-year and 2-year follow-up. Over 50% of participants had no admissions in the year subsequent to completing the group.
As this study was not a randomized controlled trial, results must be interpreted with caution. However, the findings presented here are promising, and suggest that a briefer, less resource intense version of the group skills training component of DBT may be effective in reducing deliberate self-harm.
辩证行为疗法（DBT）是一种有效的循证治疗方法，可减少故意自残行为。然而，DBT 资源和时间密集，很少有服务能够忠实地维持整个项目。因此，已经开发了修改或改编的 DBT 版本，特别是用于住院医院环境中的交付。
本研究介绍了“逆境中生存”（LTD）小组的描述，该小组基于 DBT 的小组技能培训部分。
参与者（n = 114）是一家精神病院的患者，他们参加了 LTD 小组。LTD 小组的主要纳入标准是有故意自残的病史。主要的结果衡量标准是故意自残的事件频率、痛苦容忍度水平以及每年平均住院天数。
在完成小组后，参与者报告的故意自残行为显著减少，痛苦容忍度水平显著提高，并在 3 个月随访时保持不变。参与者的平均住院天数也在 1 年和 2 年随访时减少。超过 50%的参与者在完成小组后一年内没有住院。
由于本研究不是随机对照试验，因此必须谨慎解释结果。然而，这里提出的发现是有希望的，表明 DBT 小组技能培训部分的更简短、资源密集度更低的版本可能有效减少故意自残行为。
