Long term effectiveness of dialectical behavior therapy versus enhanced usual care for adolescents with self-harming and suicidal behavior / L. MEHLUM in Journal of Child Psychology and Psychiatry, 60-10 (October 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1112-1122 Titre : Long term effectiveness of dialectical behavior therapy versus enhanced usual care for adolescents with self-harming and suicidal behavior Type de document : Texte imprimé et/ou numérique Auteurs : L. MEHLUM, Auteur ; R. K. RAMLETH, Auteur ; A. J. TORMOEN, Auteur ; E. HAGA, Auteur ; L. M. DIEP, Auteur ; B. H. STANLEY, Auteur ; A. L. MILLER, Auteur ; B. LARSSON, Auteur ; A. M. SUND, Auteur ; B. GROHOLT, Auteur Article en page(s) : p.1112-1122 Langues : Anglais (eng) Mots-clés : Self-harm  attempted suicide  longitudinal  psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Knowledge is lacking on the long-term outcomes of treatment for adolescents with repetitive suicidal and self-harming behavior. Furthermore, the pathways through which treatment effects may operate are poorly understood. Our aims were to investigate enduring treatment effects of dialectical behavior therapy adapted for adolescents (DBT-A) compared to enhanced usual care (EUC) through a prospective 3-year follow-up and to analyze possible mediators of treatment effects. METHODS: Interview and self-report data covering the follow-up interval were collected from 92% of the adolescents who participated in the original randomized trial. TRIAL REGISTRATION NUMBER: NCT01593202 (www.ClinicalTrials.gov). RESULTS: At the 3-year follow-up DBT-A remained superior to EUC in reducing the frequency of self-harm, whereas for suicidal ideation, hopelessness and depressive and borderline symptoms and global level of functioning there were no inter-group differences, with no sign of symptom relapse in either of the participant groups. A substantial proportion (70.8%) of the effect of DBT-A on self-harm frequency over the long-term was mediated through a reduction in participants' experience of hopelessness during the trial treatment phase. Receiving more than 3 months follow-up treatment after completion of the trial treatment was associated with further enhanced outcomes in patients who had received DBT-A. CONCLUSIONS: There were on average no between-group differences at the 3-year follow-up in clinical outcomes such as suicidal ideation, hopelessness, depressive and borderline symptoms. The significantly and consistently larger long-term reduction in self-harm behavior for adolescents having received DBT-A compared with enhanced usual care, however, suggests that DBT-A may be a favorable treatment alternative for adolescents with repetitive self-harming behavior. En ligne : http://dx.doi.org/10.1111/jcpp.13077 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406 [article] Long term effectiveness of dialectical behavior therapy versus enhanced usual care for adolescents with self-harming and suicidal behavior [Texte imprimé et/ou numérique] / L. MEHLUM, Auteur ; R. K. RAMLETH, Auteur ; A. J. TORMOEN, Auteur ; E. HAGA, Auteur ; L. M. DIEP, Auteur ; B. H. STANLEY, Auteur ; A. L. MILLER, Auteur ; B. LARSSON, Auteur ; A. M. SUND, Auteur ; B. GROHOLT, Auteur . - p.1112-1122. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1112-1122 Mots-clés : Self-harm  attempted suicide  longitudinal  psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Knowledge is lacking on the long-term outcomes of treatment for adolescents with repetitive suicidal and self-harming behavior. Furthermore, the pathways through which treatment effects may operate are poorly understood. Our aims were to investigate enduring treatment effects of dialectical behavior therapy adapted for adolescents (DBT-A) compared to enhanced usual care (EUC) through a prospective 3-year follow-up and to analyze possible mediators of treatment effects. METHODS: Interview and self-report data covering the follow-up interval were collected from 92% of the adolescents who participated in the original randomized trial. TRIAL REGISTRATION NUMBER: NCT01593202 (www.ClinicalTrials.gov). RESULTS: At the 3-year follow-up DBT-A remained superior to EUC in reducing the frequency of self-harm, whereas for suicidal ideation, hopelessness and depressive and borderline symptoms and global level of functioning there were no inter-group differences, with no sign of symptom relapse in either of the participant groups. A substantial proportion (70.8%) of the effect of DBT-A on self-harm frequency over the long-term was mediated through a reduction in participants' experience of hopelessness during the trial treatment phase. Receiving more than 3 months follow-up treatment after completion of the trial treatment was associated with further enhanced outcomes in patients who had received DBT-A. CONCLUSIONS: There were on average no between-group differences at the 3-year follow-up in clinical outcomes such as suicidal ideation, hopelessness, depressive and borderline symptoms. The significantly and consistently larger long-term reduction in self-harm behavior for adolescents having received DBT-A compared with enhanced usual care, however, suggests that DBT-A may be a favorable treatment alternative for adolescents with repetitive self-harming behavior. En ligne : http://dx.doi.org/10.1111/jcpp.13077 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406

Practitioner Review: Treatment for suicidal and self-harming adolescents - advances in suicide prevention care / J. R. ASARNOW in Journal of Child Psychology and Psychiatry, 60-10 (October 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1046-1054 Titre : Practitioner Review: Treatment for suicidal and self-harming adolescents - advances in suicide prevention care Type de document : Texte imprimé et/ou numérique Auteurs : J. R. ASARNOW, Auteur ; L. MEHLUM, Auteur Article en page(s) : p.1046-1054 Langues : Anglais (eng) Mots-clés : Suicide  adolescence  prevention  screening  self-harm Index. décimale : PER Périodiques Résumé : BACKGROUND: Suicide is a leading cause of death globally in youths, and suicidal behavior and self-harm are major clinical concerns. This article updates the previous practitioner review (2012) with the aims of integrating new research evidence, including that reported in this Special Issue. METHODS: The article reviews scientific evidence related to steps in the care pathway for identifying and treating youths with elevated suicide/self-harm risk, specifically: (a) screening and risk assessment; (b) treatment; and (c) community-level suicide prevention strategies. RESULTS: Review of current evidence indicates that major advances have been achieved in knowledge regarding clinical and preventive practices for reducing suicide and self-harm risk in adolescents. The evidence supports the value of brief screeners for identifying youths with elevated suicide/self-harm risk and the efficacy of some treatments for suicidal and self-harm behavior. Dialectical behavior therapy currently meets Level 1 criteria (2 independent trials supporting efficacy) as the first well-established treatment for self-harm, and other approaches have shown efficacy in single randomized controlled trials. The effectiveness of some community-based suicide prevention strategies for reducing suicide mortality and suicide attempt rates has been demonstrated. CONCLUSIONS: Current evidence can guide practitioners in delivering effective care for youth suicide/self-harm risk. Treatments and preventive interventions that address the psychosocial environment and enhance the ability of trusted adults to protect and support youths, while also addressing the psychological needs of youths appear to yield the greatest benefits. Although additional research is needed, our current challenge is to do our best to effectively utilize new knowledge to improve care and outcomes in our communities. En ligne : http://dx.doi.org/10.1111/jcpp.13130 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406 [article] Practitioner Review: Treatment for suicidal and self-harming adolescents - advances in suicide prevention care [Texte imprimé et/ou numérique] / J. R. ASARNOW, Auteur ; L. MEHLUM, Auteur . - p.1046-1054. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1046-1054 Mots-clés : Suicide  adolescence  prevention  screening  self-harm Index. décimale : PER Périodiques Résumé : BACKGROUND: Suicide is a leading cause of death globally in youths, and suicidal behavior and self-harm are major clinical concerns. This article updates the previous practitioner review (2012) with the aims of integrating new research evidence, including that reported in this Special Issue. METHODS: The article reviews scientific evidence related to steps in the care pathway for identifying and treating youths with elevated suicide/self-harm risk, specifically: (a) screening and risk assessment; (b) treatment; and (c) community-level suicide prevention strategies. RESULTS: Review of current evidence indicates that major advances have been achieved in knowledge regarding clinical and preventive practices for reducing suicide and self-harm risk in adolescents. The evidence supports the value of brief screeners for identifying youths with elevated suicide/self-harm risk and the efficacy of some treatments for suicidal and self-harm behavior. Dialectical behavior therapy currently meets Level 1 criteria (2 independent trials supporting efficacy) as the first well-established treatment for self-harm, and other approaches have shown efficacy in single randomized controlled trials. The effectiveness of some community-based suicide prevention strategies for reducing suicide mortality and suicide attempt rates has been demonstrated. CONCLUSIONS: Current evidence can guide practitioners in delivering effective care for youth suicide/self-harm risk. Treatments and preventive interventions that address the psychosocial environment and enhance the ability of trusted adults to protect and support youths, while also addressing the psychological needs of youths appear to yield the greatest benefits. Although additional research is needed, our current challenge is to do our best to effectively utilize new knowledge to improve care and outcomes in our communities. En ligne : http://dx.doi.org/10.1111/jcpp.13130 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406

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