Department of Psychology, University of Washington, Box 351525, Seattle, WA, USA.
Duke Global Health Institute, 310 Trent Drive, Durham, NC, USA.
J Clin Psychol. 2018 Jul;74(7):1071-1091. doi: 10.1002/jclp.22588. Epub 2018 Feb 19.
Suicide in low- and middle-income countries (LMICs) accounts for 75% of the world's burden of suicide mortality and is the leading single cause of death among Nepali reproductive age women. To advance treatment for suicidal behaviors in LMICs, a single-case experimental design (SCED) was conducted of a culturally adapted Dialectical Behavior Therapy skills intervention for Nepali populations (DBT-N).
Ten Nepali women with histories of suicidality participated in the 10-session intervention. Outcomes of emotion regulation, suicidal ideation, depression, anxiety, resilience, and coping skills use were measured at multiple time points pre-intervention, during, and at follow-up. Qualitative interviewing assessed DBT-N's feasibility and acceptability.
Participants showed improvements in emotion regulation over the course of treatment, which were associated with increased skills use. Rapid, sustained reductions in suicidal ideation and improvements in resilience were observed after DBT-N initiation.
This SCED supports conducting further evaluation of DBT-N through controlled trials with emotion regulation as a target mechanism of action for reducing suicidal behaviors in LMICs.
中低收入国家（LMICs）的自杀率占全球自杀死亡率的 75%，是尼泊尔育龄期女性的主要死因。为了推进对 LMICs 自杀行为的治疗，我们对一种文化适应性的辩证行为治疗技能干预措施（DBT-N）进行了单病例实验设计（SCED），以治疗尼泊尔人群。
10 名有自杀史的尼泊尔女性参加了 10 节干预课程。在干预前、干预中和随访期间，通过多次时间点测量，评估了情绪调节、自杀意念、抑郁、焦虑、韧性和应对技能的使用情况。定性访谈评估了 DBT-N 的可行性和可接受性。
参与者在治疗过程中表现出情绪调节的改善，这与技能使用的增加有关。DBT-N 启动后，自杀意念迅速、持续减少，韧性提高。
这项 SCED 支持通过对照试验进一步评估 DBT-N，将情绪调节作为减少 LMICs 自杀行为的作用机制。
