title: Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial.
abstract: OBJECTIVE
  We examined whether a shortened form of dialectical behavior therapy, dialectical behavior therapy for adolescents (DBT-A) is more effective than enhanced usual care (EUC) to reduce self-harm in adolescents.
  
  
  METHODS
  This was a randomized study of 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics who were randomly allocated to either DBT-A or EUC. Assessments of self-harm, suicidal ideation, depression, hopelessness, and symptoms of borderline personality disorder were made at baseline and after 9, 15, and 19 weeks (end of trial period), and frequency of hospitalizations and emergency department visits over the trial period were recorded.
  
  
  RESULTS
  Treatment retention was generally good in both treatment conditions, and the use of emergency services was low. DBT-A was superior to EUC in reducing self-harm, suicidal ideation, and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT-A, whereas effect sizes were small for outcomes in patients receiving EUC. Total number of treatment contacts was found to be a partial mediator of the association between treatment and changes in the severity of suicidal ideation, whereas no mediation effects were found on the other outcomes or for total treatment time.
  
  
  CONCLUSIONS
  DBT-A may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior. Clinical trial registration information-Treatment for Adolescents With Deliberate Self Harm; http://ClinicalTrials.gov/; NCT00675129.
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: lars.mehlum@medisin.uio.no.
authors.forename: Lars
authors.initials: L
authors.lastname: Mehlum
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Tørmoen
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Ramberg
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Egil
authors.initials: E
authors.lastname: Haga
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Lien M
authors.initials: LM
authors.lastname: Diep
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Stine
authors.initials: S
authors.lastname: Laberg
authors.affiliation: Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Bo S
authors.initials: BS
authors.lastname: Larsson
authors.affiliation: Columbia University, New York City, and the University of Oslo, Norway.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Stanley
authors.affiliation: Montefiore Medical Center and Albert Einstein College of Medicine, New York City.
authors.forename: Alec L
authors.initials: AL
authors.lastname: Miller
authors.affiliation: Norwegian University of Science and Technology and St Olav's University Hospital, Trondheim, Norway.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Sund
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Grøholt
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D016037:Single-Blind Method; D013406:Suicide, Attempted / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: attempted suicide; psychotherapy; randomized trial; self-harm