Remission, Recovery, Relapse, and Recurrence Rates for Suicide Attempts and Nonsuicidal Self-Injury for Suicidal Youth Treated With Dialectical Behavior Therapy or Supportive Therapy

Michele S Berk; Robert Gallop; Joan R Asarnow; Molly C Adrian; Jennifer L Hughes; Elizabeth McCauley

doi:10.1016/j.jaac.2024.01.012

Remission, Recovery, Relapse, and Recurrence Rates for Suicide Attempts and Nonsuicidal Self-Injury for Suicidal Youth Treated With Dialectical Behavior Therapy or Supportive Therapy

J Am Acad Child Adolesc Psychiatry. 2024 Feb 5:S0890-8567(24)00059-5. doi: 10.1016/j.jaac.2024.01.012. Online ahead of print.

Authors

Michele S Berk¹, Robert Gallop², Joan R Asarnow³, Molly C Adrian⁴, Jennifer L Hughes⁵, Elizabeth McCauley⁴

Affiliations

¹ Stanford University, Stanford, California. Electronic address: mberk2@stanford.edu.
² West Chester University of Pennsylvania, West Chester, Pennsylvania.
³ University of California, Los Angeles, California.
⁴ University of Washington, Seattle, Washington.
⁵ Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University, Columbus, Ohio; and UT Southwestern Medical Center, Dallas, Texas.

PMID: 38325518
DOI: 10.1016/j.jaac.2024.01.012

Abstract

Objective: To evaluate rates of remission, recovery, relapse, and recurrence in suicidal youth who participated in a clinical trial comparing Dialectical Behavior Therapy (DBT) and Individual and Group Supportive Therapy (IGST).

Method: Participants were 173 youth, aged 12 to 18 years, with repetitive self-harm (including at least 1 prior suicide attempt [SA]) and elevated suicidal ideation (SI). Participants received 6 months of DBT or IGST and were followed for 6 months post-treatment. The sample was 95% female, 56.4% White, and 27.49% Latina. Remission was defined as absence of SA or nonsuicidal self-injury (NSSI) across one 3-month interval; recovery was defined across 2 or more consecutive intervals. Relapse and recurrence were defined as SA or NSSI following remission or recovery. Cross-tabulation with χ² was used for between-group contrasts.

Results: Over 70% of the sample reported remission of SA at each treatment and follow-up interval. There were significantly higher rates of remission and recovery and lower rates of relapse and recurrence for SA in DBT than for IGST. Across treatments and time points, SA had higher remission and recovery rates and lower relapse and recurrence rates than NSSI. There were no significant differences in NSSI remission between conditions; however, participants receiving DBT had significantly higher NSSI recovery rates than those receiving IGST for the 3- to 9-month, 3- to 12-month, and 6- to 12-month intervals.

Conclusion: Results showed higher percentages of SA remission and recovery for DBT as compared to IGST. NSSI was less likely to remit than SA.

Diversity & inclusion statement: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants.

Clinical trial registration information: Collaborative Adolescent Research on Emotions and Suicide (CARES); https://www.

Clinicaltrials: gov/; NCT01528020.

Keywords: adolescent; dialectical behavior therapy; nonsuicidal self-injury; self-harm; suicide.

Associated data

ClinicalTrials.gov/NCT01528020

Grants and funding

R01 MH093898/MH/NIMH NIH HHS/United States