New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
Behav Cogn Psychother. 2019 Sep;47(5):616-621. doi: 10.1017/S1352465819000122. Epub 2019 Mar 21.
Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied.
This study sought to evaluate the feasibility and acceptability of DBT-SG in Veterans and to gather preliminary evidence for its efficacy in reducing suicidal ideation and emotion dysregulation and increasing coping skills.
Veterans with suicidal ideation and emotion dysregulation (N = 17) enrolled in an uncontrolled pilot study of a 26-week DBT-SG as an adjunct to mental health care-as-usual.
Veterans attended an average 66% of DBT-SG sessions. Both Veterans and their primary mental health providers believed DBT-SG promoted Veterans' use of coping skills to reduce suicide risk, and they were satisfied with the treatment. Paired sample t-tests comparing baseline scores with later scores indicated suicidal ideation and emotion dysregulation decreased at post-treatment (d = 1.88, 2.75, respectively) and stayed reduced at 3-month follow-up (d = 2.08, 2.59, respectively). Likewise, skillful coping increased at post-treatment (d = 0.85) and was maintained at follow-up (d = 0.91).
An uncontrolled pilot study indicated DBT-SG was feasible, acceptable, and demonstrated potential efficacy in reducing suicidal ideation and emotion dysregulation among Veterans. A randomized controlled study of DBT-SG with Veterans at risk for suicide is warranted.
退伍军人自杀风险较高;情绪调节障碍可能会增加风险。辩证行为疗法(DBT)是一种针对情绪调节障碍个体减少自杀企图的有效干预措施,但它较为复杂,包含多个组成部分。DBT 的技能组部分(DBT-SG)与减少自杀意念和情绪调节障碍有关。但针对有自杀风险的退伍军人的 DBT-SG 尚未得到研究。
本研究旨在评估 DBT-SG 在退伍军人中的可行性和可接受性,并初步收集其在降低自杀意念和情绪调节障碍以及增加应对技能方面的疗效证据。
患有自杀意念和情绪调节障碍的退伍军人(N=17)参加了一项为期 26 周的 DBT-SG 作为辅助心理健康治疗的非对照试点研究。
退伍军人平均参加了 66%的 DBT-SG 课程。退伍军人及其主要心理健康提供者都认为 DBT-SG 促进了退伍军人使用应对技能来降低自杀风险,并且他们对治疗感到满意。配对样本 t 检验比较基线分数和后期分数表明,自杀意念和情绪调节障碍在治疗后减少(d=1.88,2.75),在 3 个月随访时仍保持减少(d=2.08,2.59)。同样,应对技能在治疗后增加(d=0.85),并在随访时保持(d=0.91)。
一项非对照试点研究表明,DBT-SG 是可行的、可接受的,并在降低退伍军人自杀意念和情绪调节障碍方面显示出潜在的疗效。需要对有自杀风险的退伍军人进行 DBT-SG 的随机对照研究。