This article is more than 5 years old. Information may no longer be current.

Varying DBT interventions reduces suicide attempts, self-injury in women with BPD

Suicide attempts and non-suicidal self-injurious behaviors among suicidal women with borderline personality disorder were reduced by various dialectical behavior therapy interventions, according to data published in JAMA Psychiatry.

The researchers compared standard dialectical behavior therapy (DBT), DBT skills training (DBT-S) and DBT individual therapy (DBT-I) to determine the frequency/severity of suicide attempts and nonsuicidal self-injury among 99 women from April 2004 through January 2010.

Patients (mean age, 30.3 years) with borderline personality disorder who had at least two suicide attempts or nonsuicidal self-injury acts within the last 5 years, had a nonsuicidal self-injury act or suicide attempt in the 8 weeks prior to the study, and a suicide attempt in the past year were included in the single-blind randomization trial to the three DBT groups.

“All [three] conditions resulted in significantly reduced suicide attempts, suicide ideation, medical severity of intentional self-injury, use of crisis services owing to suicidality, and improved reasons for living,” Marsha M. Linehan, PhD, of the Behavioral Research and Therapy Clinics in the department of psychology at the University of Washington, Seattle, and colleagues wrote.

During the treatment year, interventions that included skills training significantly improved the frequency of nonsuicidal self-injury acts in standard DBT and DBT-S (P < .001); and depression (P = .03 for standard DBT; P = .01 for DBT-S), compared with the DBT-I group, according to data.

Anxiety among patients also significantly improved with standard DBT (P < .001) and DBT-S (P = .01), but not with DBT-I, the researchers wrote.

Those assigned to standard DBT were also less likely to drop out of treatment, compared with the DBT-I group (8 vs. 16; P = .04). At follow-up, patients assigned to standard DBT were also less likely to use crisis services (P = .02) and psychiatric hospitalizations (P = .03), compared with those assigned to DBT-I, the researchers wrote.– by Samantha Costa

Disclosure: Linehan reports royalties from Guilford Press for books she has written on DBT and from Behavioral Tech, LLC, for DBT training materials she has developed. Please see the full study for a list of all other authors’ relevant financial disclosures.