Suzanne E Decker1,2, Lynette Adams2,3, Laura E Watkins2,4, Lauren M Sippel2,4, Jennifer Presnall-Shvorin3, Mehmet Sofuoglu1,2, Steve Martino1,2. 1. New England Mental Illness Research, Education, and Clinical Center, West Haven, CT 06516, USA. 2. Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA. 3. Mental Health Service Line, Psychology Section, VA Connecticut Health Care System, West Haven, CT 06516, USA. 4. National Center for PTSD Clinical Neurosciences Division, West Haven, CT 06516, USA.
Abstract
BACKGROUND: 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. AIMS: 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. METHOD: 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. RESULTS: 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). CONCLUSIONS: 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.
BACKGROUND: 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. AIMS: 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. METHOD: 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. RESULTS: 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). CONCLUSIONS: 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.
Authors: Marsha M Linehan; Kathryn E Korslund; Melanie S Harned; Robert J Gallop; Anita Lungu; Andrada D Neacsiu; Joshua McDavid; Katherine Anne Comtois; Angela M Murray-Gregory Journal: JAMA Psychiatry Date: 2015-05 Impact factor: 21.596
Authors: Marianne Goodman; David Banthin; Nicholas J Blair; Kathryn A Mascitelli; Jaime Wilsnack; Jennifer Chen; Julie W Messenger; M Mercedes Perez-Rodriguez; Joseph Triebwasser; Harold W Koenigsberg; Raymond R Goetz; Erin A Hazlett; Antonia S New Journal: J Clin Psychiatry Date: 2016-12 Impact factor: 4.384