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一项互联网提供的辩证行为治疗技能训练对有自杀和重度发作性饮酒者的随机对照试验。

A randomized controlled trial of an Internet delivered dialectical behavior therapy skills training for suicidal and heavy episodic drinkers.

机构信息

University of Washington, 3917 University Way, Seattle, WA 98195, USA.

Lyra Health, 205 Park Rd, Burlingame, CA 98010, USA.

出版信息

J Affect Disord. 2018 May;232:219-228. doi: 10.1016/j.jad.2018.02.053. Epub 2018 Feb 17.

Abstract

BACKGROUND

Given that alcohol misuse elevates risk of suicide death among ideators, the paucity of treatment outcome research for individuals presenting with both suicide ideation and problem drinking is particularly troubling. Dialectical behavior therapy (DBT) skills training, which effectively targets behaviors associated with emotion dysregulation including addictive and suicidal behaviors, provides a fitting model amenable to computerization. As stigma and scarcity stand as potential barriers to treatment, online dissemination platforms provide means for efficient treatment delivery that can augment the utility of suitable interventions. This pilot RCT sought to evaluate the feasibility, acceptability, and preliminary efficacy of an Internet-delivered DBT skills training intervention (iDBT-ST) for suicidal individuals who engage in heavy episodic drinking METHODS: Participants (N = 59) were randomized to receive iDBT-ST immediately or after an 8-week waiting period. Clinical outcomes were suicide ideation, alcohol use, and emotion dysregulation.

RESULTS

Participants on average saw a significant reduction in all outcomes over the four-month study period. Compared to waitlist controls, individuals who received iDBT-ST immediately showed faster reductions in alcohol consumption.

CONCLUSIONS

Preliminary results suggest that iDBT-ST may be a viable resource for the high-risk and underserved group represented in this study, and pathways for future development are suggested.

LIMITATIONS

There was difficulty retaining and engaging participants due to technological barriers.

摘要

背景

由于酗酒会增加有自杀意念者的自杀死亡风险,因此,对于同时存在自杀意念和酗酒问题的个体,治疗效果研究的缺乏尤其令人困扰。辩证行为疗法(DBT)技能训练有效地针对与情绪失调相关的行为,包括成瘾和自杀行为,提供了一个适合计算机化的模型。由于耻辱感和资源匮乏可能成为治疗的障碍,在线传播平台为高效治疗提供了手段,从而增强了合适干预措施的效用。这项先导性 RCT 旨在评估针对大量饮酒的自杀个体的互联网提供的 DBT 技能训练干预(iDBT-ST)的可行性、可接受性和初步疗效。

方法

参与者(N=59)被随机分配到立即接受 iDBT-ST 或在 8 周的等待期后接受 iDBT-ST。临床结果是自杀意念、酒精使用和情绪失调。

结果

参与者在四个月的研究期间平均所有结果都有显著降低。与等待名单对照组相比,立即接受 iDBT-ST 的个体在酒精消耗方面的减少速度更快。

结论

初步结果表明,iDBT-ST 可能是该研究中代表的高风险和服务不足群体的可行资源,并提出了未来发展的途径。

局限性

由于技术障碍,难以留住和吸引参与者。

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