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辩证行为疗法治疗有自残行为和自杀倾向的青春期女性的情绪失调和创伤症状:一项基于社区的儿童和青少年心理健康服务中的试点项目

Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adolescent Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service.

作者信息

Geddes Keren, Dziurawiec Suzanne, Lee Christopher William

机构信息

Rockingham Kwinana Child and Adolescent Mental Health Service, P.O. Box 288, Rockingham, WA 6968, Australia.

出版信息

Psychiatry J. 2013;2013:145219. doi: 10.1155/2013/145219. Epub 2013 Jun 12.

Abstract

Background. The literature suggests a link between childhood trauma and maladaptive emotion regulation strategies, including nonsuicidal self-injury (NSSI) and suicidality. We assessed the impact of a pilot dialectical behaviour therapy (DBT) programme on reducing trauma-related symptoms and improving emotional regulation, suicidality, and NSSI in adolescents. Methods. Six adolescents attending a community mental health service received 26 weeks of DBT, together with a parent. Independent assessors collected measures on each participant at baseline, posttreatment, and three-month followup. We implemented further improvements over past research with the use of adolescent-specific outcome measures as well as independent assessment of treatment integrity, noted as problematic in previous studies, using videotapes. Results. Firstly, adolescents reported a decrease in trauma-based symptoms, suicidality, and NSSI following participation in the DBT programme that was maintained at the three-month followup. Secondly, adolescents also reported improved emotion regulation immediately following treatment, and this was maintained, albeit more moderately, three months later. Given the burgeoning demand on mental health services, it is notable that five of the six adolescents were discharged from the service following the DBT intervention. Conclusions. The results of this pilot programme suggest that DBT has the potential to improve the symptoms of this at-risk population.

摘要

背景。文献表明童年创伤与适应不良的情绪调节策略之间存在联系,包括非自杀性自伤(NSSI)和自杀倾向。我们评估了一项辩证行为疗法(DBT)试点项目对减少青少年创伤相关症状、改善情绪调节、自杀倾向和非自杀性自伤的影响。方法。六名接受社区心理健康服务的青少年与一名家长一起接受了26周的辩证行为疗法。独立评估人员在基线、治疗后和三个月随访时对每位参与者进行测量。我们通过使用针对青少年的特定结果测量方法以及对治疗完整性进行独立评估(在以往研究中被认为存在问题,此次通过录像带进行),在过去研究的基础上进一步改进。结果。首先,青少年报告称参与辩证行为疗法项目后,基于创伤的症状、自杀倾向和非自杀性自伤有所减少,且在三个月随访时保持这一状态。其次,青少年还报告称治疗后情绪调节立即得到改善,三个月后虽改善程度有所降低,但仍得以维持。鉴于对心理健康服务的需求不断增长,值得注意的是,六名青少年中有五名在接受辩证行为疗法干预后从该服务机构出院。结论。该试点项目的结果表明,辩证行为疗法有可能改善这一高危人群的症状。

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