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Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot

  • Suzanne E. Decker (a1) (a2), Lynette Adams (a2) (a3), Laura E. Watkins (a2) (a4), Lauren M. Sippel (a2) (a4), Jennifer Presnall-Shvorin (a3), Mehmet Sofuoglu (a1) (a2) and Steve Martino (a1) (a2)...

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.

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Authors’ present addresses: Dr Watkins is now at Department of Psychiatry, Emory University Medical Center, Atlanta, GA, USA; Dr Sippel is now at National Center for PTSD, White River Junction, VT, USA; Dr. Presnall-Shvorin is now at the War Related Illness and Injury Study Center (WRIISC) of VA New Jersey Health Care System, East Orange, NJ, USA.

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References

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Goodman, M., Banthin, D., Blair, N. J., Mascitelli, K. A., Wilsnack, J., Chen, J., et al. (2016). A randomized trial of dialectical behavior therapy in high-risk suicidal Veterans. Journal of Clinical Psychiatry, 77, e15911600. doi: 10.4088/JCP.15m10235
Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., et al. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371390.
Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry, 72, 475482. doi: 10.1001/jamapsychiatry.2014.3039
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T. and Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial. Behaviour Research and Therapy, 59, 4051. doi: 10.1016/j.brat.2014.05.005
Office of Suicide Prevention (2016). Suicide among Veterans and other Americans. Washington, DC: Department of Veterans Affairs.
Shelef, L., Fruchter, E., Hassidim, A. and Zalsman, G. (2015). Emotional regulation of mental pain as moderator of suicidal ideation in military settings. European Psychiatry, 30, 765769.

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Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot

  • Suzanne E. Decker (a1) (a2), Lynette Adams (a2) (a3), Laura E. Watkins (a2) (a4), Lauren M. Sippel (a2) (a4), Jennifer Presnall-Shvorin (a3), Mehmet Sofuoglu (a1) (a2) and Steve Martino (a1) (a2)...
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