Effect of Dialectical Behavioral Therapy on Suicidal Attempts and Non- Suicidal Self-Injury among Depressed Patients

Document Type : Original Article

Authors

1 Portsaid University

2 Psychiatric Therapist, Mental Health Hospital

Abstract

Background: Dialectical Behavioral Therapy is a modality of cognitive behavioral therapy, which directs the process on the synthesis of opposites and the modification of maladaptive behaviors. It cognizes individuals with four significant compounds of skills to manage massive emotions, and innervate coping skills. Aim: This study aimed to evaluate the effect of dialectical behavioral therapy on depressed patients' suicidal attempts and non- suicidal self-injuries. Subjects &Method: Design: A control time- series quasi-experimental research design used. Setting:Eastern Governance for mental health hospital. Subjects: A total number of 40 patients participated in the study. Tools: Hamilton Depression Rating Scale, Non-Suicidal Self-Injury Assessment Tool and Lineman Suicide Attempt-Self-Injury Interview were used in data collection. Results: Significant reduction in suicidal attempts’ mean scores throughout the program and follow up phases among the DBT group with high effect size procured between both DBT and usual care groups ( Cohen’s d = ranged from  0.500000 to 1.31689). Conclusion: This research showed that Dialectical Behavioral Therapy is a salutary, profitable and pre-eminent approach can be used with suicidal and NSSI patients as compared to usual care. Recommendations: There is imperious need to expand the use of this therapy with psychiatric patients (e.g. anxiety disorders; PTSD patients).
 

Keywords

Main Subjects

References

Albataineh, A. (2017). Psychosocial determinants of suicidal ideation among the women. Published dissertation. Kent State University College of Nursing. Available at: https://etd.ohiolink.edu/!etd.send_file?accession=kent1509996779943675&disposition=inline
 
Andreasson, K., Krogh, J., Rosenbaum, B., Gluud, C., Jobes, D.A., & Nordentoft, M. (2017). The Dias trial: dialectical behavior therapy versus collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits - study protocol for a randomized controlled trial. Depression and anxiety, 33(6), 520‐530.https://doi.org/10.1002/da.22472
 
Beck, A., Kovacs, M., & Weissman, A. (1979). Assessment of Suicidal Intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2): 343-352. Retrieved from: https://pdfs.semanticscholar.org/c2de/a047d5d71cd6500d92d4cdf2c6e36129d8cf.pdf
 
Breton, J., Labelle, R., Berthiaume, C., Royer, C., St-Georges, M., Ricard, D., & Guilé, M. (2015). Protective factors against depression and suicidal behavior in adolescence.
 
 Canadian journal of psychiatry. Revue canadienne de psychiatrie, 60(2Suppl 1), S5.Retrieved from :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345848/
 
Chapman, A., Gratz, K., Matthew, T., & Kean, T. (2011). The Dialectical Behavior Therapy Skills Workbook for Anxiety. New Harbinger Publications. Pp:1-184.
 
Dalglish, L., Melchior, M., Younes, N., & Surkan, J. (2015). Work characteristics and suicidal ideation in young adults in France. Social Psychiatry and Psychiatric Epidemiology, 50(4), 613-620. doi:10.1007/s00127-014-0969-y
 
Dimeff, L., & Linehan,M. (2008). Dialectical Behavior Therapy for Substance Abusers. Addiction Science & Clinical Practice, 4(2), 39-47.doi: 10.1151/ascp084239
 
Duhoux, A., Fournier, L., Gauvin, L., & Roberge, P. (2013). What is the association between quality of treatment for depression and patient outcomes? A cohort study of adults consulting in primary care. Journal of Affective Disorders. 151: 265–274. https://doi.org/.10.1016/j.jad.2013.05.097 .

Fitzpatrick, S., Bailey, K., & Rizvi, S. (2020). Changes in Emotions over the Course of Dialectical Behavior Therapy and the Moderating Role of Depression, Anxiety, and Posttraumatic Stress Disorder. Behavior Therapy, 51(6): 946-57.doi: 10.1016/j.beth.2019.12.009.

Flynn, D., Gillespie, C., Joyce, M.,  & Spillane, A. (2020). An evaluation of the skills group component of DBT-A for parent/guardians: a mixed methods study. Irish journal of psychological medicine. 1-9. 10.1017/ipm.2019.62.
 
Habibi, M., Akbari-Pourbahadoran, M., Falahatpishe-Baboli, M., Narimani, M., & Abedi-Parija, H. (2016): Effectiveness of dialectical behavior therapy in improving symptoms of patients with dysthymic disorder. Journal of Health and Care. 17(4):329-339. Retrieved from : http://hcjournal.arums.ac.ir/article-1-414-en.html
 
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry. 23: 56–62. Retrieved from: https://www.psychcongress.com/hamilton-depression-rating-scale-ham-d. doi:10.1136/jnnp.23.1.56 PMID 14399272
 
Han, J., & Richardson, V. (2010).The Relationship Between Depression and Loneliness Among Homebound Older Persons: Does Spirituality Moderate This Relationship?. Journal of Religion & Spirituality in Social Work: Social Thought, 29:218–236. doi: 10.1080/15426432.2010.495610
 
Hassan, M., & Hassan, H. (2016): Behavioral therapy on clinical symptoms, body image, and self-efficacy of people with bulimia disorder. Mediterranean Journal of Social Sciences. Doi:10.5901/mjss.2016.v7n3s3p136.
Huffman, J., Celano, CH., Beach, S., Motiwala, S., & Januzzi, J. (2013). Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis. Cardiovascular Psychiatry and Neurology Journal, Article ID 695925. http://dx.doi.org/10.1155/2013/695925
Jourdy, R., & Jean-Michel, P. (2017). Relationships between personality traits and depression in the light of the “Big Five” and their different facets. L'ÉvolutionPsychiatrique. 82(4): e27-e37. https://doi.org/10.1016/j.evopsy.2017.08.002.
 
Kells, M., Joyce, M., &Flynn, D.  (2020). Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours. Borderline personality disorders emotional dysregulations, 7(3): 1-8.Retrieved from:https://doi.org/10.1186/s40479-020-0119-y
 
khani, H., Belir, S., Zamani, S., & Zamani, N. (2015). Efficacy of dialectical behavioral therapy on depression. Journal of Mazandaran University of Medical Sciences. 25(127): 113-118. Available at: http://jmums.mazums.ac.ir/article-1-5942-en.html.
 
Kim, J.,  Moon, S.,   Kim, H., & Lee, D. (2017). Relationship between Chronic Kidney Disease and Depression in Elderly Koreans Using the 2013 Korea National Health and Nutrition Examination Survey Data. Korean Journal of Family Medicine, 38(3): 156–162.doi:  10.4082/kjfm.2017.38.3.156
 
Klonsky, E., & Olino, T. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis. Journal of Consulting and Clinical Psychology, 76: 22-27. doi: 10.1037/0022-006X.76.1.22.
 
Krantz,  H., McMain,S., & Kuo, J.R.  (2018). The unique contribution of acceptance without judgment in predicting non-suicidal self-injury after 20-weeks of dialectical behaviour therapy group skills training. Behavior Research Therapy; 104:44-50. doi: 10.1016/j.brat.2018.02.006. Epub.
 
Li, H., Luo, X., Ke, X., Dai, Q., Zheng, W., Zhang, C., & Ning, Y. (2017). Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population. PLoS ONE, 12(10), e0186143. http://doi.org/10.1371/journal.pone.0186143
 
Linehan, M. (2014). DBT® Skills Training Manual, Second Edition. New York: Guilford Press.
Linehan, M. (2015). DBT skills training manual. 2nd ed. The Guilford Press. New York. Pp. 82.
 
Linehan, M., Comtois, A., Brown, Z., Heard, L., &Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18(3), 303-312.Available at: http://www.selfinjury.bctr.cornell.edu/perch/resources/suicide-attempt-self-injury-interview-sasii-1.pdf
 
Linehan, M., Korslund, E., Harned, M.,S, Gallop, R.,Lungu, A., Neacsiu, D., McDavid, J.,Comtois, K., &Murray-Gregory, A.(2015): Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder/a randomized clinical trial and component analysis. JAMA Psychiatry. 72(5):475–482.doi:10.1001/jamapsychiatry.2014.3039
 
Manna , V., Falgares ,G.,  Ingoglia , S., Como , M., &De Santis, S. (2016). The Relationship between Self-Esteem, Depression and Anxiety: Comparing Vulnerability and Scar Model in the Italian Context. Mediterranean Journal of Clinical Psychology MJCP. 4 (3). Doi: 10.6092/2282-1619/2016.4.1328

McCauley, E., Berk, M., & Asarnow, J. (2018). Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA Psychiatry, 75(8):777-785. doi:10.1001/jamapsychiatry. 2018.1109

McMain, S.F., Chapman, A.L., Kuo, J.R. Guimond, T., Streiner, D., Dixon-Gordon, K., Isaranuwatchai, W., & Hoch, J. (2018).The effectiveness of 6 versus 12-months of dialectical behaviour therapy for borderline personality disorder: the feasibility of a shorter treatment and evaluating responses (FASTER) trial protocol. BMC Psychiatry, 18, 230. https://doi.org/10.1186/s12888-018-1802-z
 
Mehlum, L., Toromoen, A., Ramberg, M., Haga, E., Diep, L., Laberg, S., Larsson, B., Stanely, B., Miller, A., Sund, A., & Groholt, B. (2014). Dialectical behavioral therapy for adolescents with repeated suicidal and self- harming behavior: A randomized trial. Journal of the American Academy for Child & Adolescent Psychiatry, 53 (10): 1082- 1089.doi: 10.1016/j.jaac.2014.07.003. 
Mehlum, L., Toromoen, A., Ramberg, M., Haga, E., Diep, L., Laberg, S., Larsson, B., Stanely, B., Miller, A., Sund, A., & Groholt, B. (2019). Long term effectiveness of dialectical behavior therapy versus enhanced usual care for adolescents with self‐harming and suicidal behavior. Journal of Child Psychology and Psychiatry, 69(10): 1112-1122. https://doi.org/10.1111/jcpp.13077
 
Ng, C., How, C., &Ng, Y. (2017). Depression in primary care: assessing suicide risk. Singapore Medical Journal, 58(2), 72–77. http://doi.org/10.11622/smedj.2017006
 
Park, S., Lee, Y., Youn, T.  Kim, B., Park, J., Kim, H.,  Lee, H., &Hong, J. (2018). Association between level of suicide risk, characteristics of suicide attempts, and mental disorders among suicide attempters. BMC Public Health, 18, 477. https://doi.org/10.1186/s12889-018-5387-8
 
Prada, P., Perroud, N., Rüfenacht, E., &Nicastro, R. (2018). Strategies to Deal with Suicide and Non-suicidal Self-Injury in Borderline Personality Disorder, the Case of DBT. Psychotherapeutic Research, 29: 1074-85. https://doi.org/10.3389/fpsyg.2018.02595
 
Renner, F., Penninx, B., Peeters, F., Cuijpers, P., & Huibers, M. (2013). Two-year stability and change of neuroticism and extraversion in treated and untreated persons with depression: findings from the Netherlands study of depression and anxiety (NESDA). Journal of Affect Disorders, 150 (2), 201-208.doi: 10.1016/j.jad.2013.03.022.
 
Shani, C., Yelena, S., Reut, K., Adrian, S., &Sami, H. (2016). Suicidal risk among infertile women undergoing in-vitro fertilization: Incidence and risk factors. Psychiatry research, 240, 53-59.doi: 10.1016/j.psychres.2016.04.003.
 
Shanmugasegaram, K., Russell, A., Kovacs, D., & Grace, S. (2012).Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis.  Maturitas. 73(4). 305–311.doi: 10.1016/j.maturitas.2012.09.005
 
Shenouda, N.,& Basha, E. (2014). Resilience, Social support, and stress as predictors of suicide ideation among public universities' students in Egypt. OIDA International Journal of Sustainable Development, 7(8), 37-66. Available at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2508552
 
Slomski, A. (2018). Behavior Therapy May Help Prevent Teen Suicide. JAMA. Psychiatry; 320(8):749. doi:10.1001/jama.2018.12044
 
Soler, J., Valdepérez, A., Feliu-Soler, A., Pascual,JC.,Portella, MJ., Martín-Blanco, A., Alvarez, E., & Pérez, V. (2012). Effects of the dialectical behavioral therapy-mindfulness module on attention in patients with borderline personality disorder. Behavioral Research Therapy. 50(2):150-7. doi: 10.1016/j.brat.2011.12.002. Epub 2011 Dec 14.
 
Sowislo, F., Orth, U., & Meier, L. (2014). What constitutes vulnerable self-esteem? Comparing the prospective effects of low, unstable, and contingent self-esteem on depressive symptoms. Journal of Abnormal Psychology, 123(4), 737-53. doi: 10.1037/a0037770.
 
Stepp, S., Epler,A.,Jahng, S., &Trull T. (2013).The effect of dialectical behavior therapy skills use on borderline personality disorder features. Journal of Personality Disorders, 22(6), 549–563.http://doi.org/10.1521/pedi.2008.22.6.549
 
Takeuchi, T., &Nakao, M. (2013). The relationship between suicidal ideation and symptoms of depression in Japanese workers: a cross-sectional study.BMJ Open 2013;3:e003643.doi: 10.1136/bmjopen-2013-003643
 
Thyer, A. (2010):    Handbook of social work research methods.   Thousand Oaks, CA:  Sage Publications, Inc.
 
Van, S., Jeffrey, J., &Katz, M.R. (2013). A randomized, controlled, pilot study of dialectical behavior therapy skills in a psycho-educational group for individuals with bipolar disorder. Journal of Affective Disorders,145:386-93.doi: 10.1016/j.jad.2012.05.054.
 
Wang, Y., Shi, Z., &Luo, Q. (2017). Association of depressive symptoms and suicidal ideation among university students in China- A systematic review and meta-analysis. Medicine (Baltimore), 96(13):1-7. http://dx.doi.org/   10.1097/MD.0000000000006476.
Whitlock, J., Exner-Cortens, D.,&Purington, A. (2007). Validity andreliability of the non-suicidal self-injury assessment test (NSSI-AT).The Cornell Research Program on Self-Injury and Recovery. Available at: http://www.selfinjury.bctr.cornell.edu/perch/resources/fnssi.pdf
 
Whittier, AB., Gelaye, B., Deyessa, N., Bahretibeb, Y., Kelkile, TS.,&Berhane, Y., (2016). Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital. Journal of Affective Disorders. 197: 58–65. https://doi.org/.10.1016/j.jad.2016.02.052 .
 
Yeo, A.J., German, M., Wheeler, K., Camacho, E., Hirsch, A., &Miller. A. (2020). Self-harm and self-regulation in urban ethnic minority youth: a pilot application of dialectical behavior therapy for adolescents. Addiction Behavior, 98, Article 106035. https://doi.org/10.1111/camh.12374
 
Yu-Hang, W., Zhou-Ting, S., &Qian-Ying, L.(2017). Association of depressive symptoms and suicidal ideation among university students in China: A systematic review and meta-analysis. Medicine: 96(13):p e6476.doi: 10.1097/MD.0000000000006476
 
Zamani, N., Farhadi, M, Zamani, S., &Jahangir., A. (2017). The effectiveness of dialectic behavioral therapy on depression in women with multiple sclerosis. Health Research Journal, 2(1): 1-8. doi: 10.18869/acadpub.hrjbaq.2.1.1.
Port Said Scientific Journal of Nursing
Volume 9, Issue 3
December 2022
Pages 214-243

Files

Share

How to cite

Statistics