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

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