Dialectical Behavior Therapy for Adolescent Binge Eating, Purging, Suicidal Behavior, and Non-Suicidal Self-injury: A Pilot Study
Dialectical Behavior Therapy for Adolescent Binge Eating, Purging, Suicidal Behavior, and Non-Suicidal Self-injury: A Pilot Study
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DOI：
10.1037/a0036065
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发表时间：
2015-03-01
期刊：
影响因子：
2.5
通讯作者：
Peterson, Claire
中科院分区：
文献类型：
--
作者：
Fischer, Sarah;Peterson, Claire
很少有已发表的随机对照试验检验青少年神经性贪食症 (BN) 症状的治疗方法。此外，许多因 BN 症状而接受治疗的青少年认可同时发生的情绪障碍、自杀和非自杀性自伤 (NSSI)，并且可能不符合 BN 的完整诊断和统计手册 IV 文本修订 (DSM-IV-TR) 诊断标准。除了数量有限的随机对照试验外，已发表的青春期 BN 症状的治疗研究并没有具体解决这些青少年经常报告的多种合并症症状。这项试点研究的目的是检验针对具有 BN、自杀未遂和 NSSI 症状的青少年的门诊辩证行为治疗 (DBT) 计划的可行性和有效性。十名符合资格的参与者参加了该研究； 3 在开始治疗后 4 周内下降。除了暴饮暴食和自杀行为外，参与者还认可了许多其他共病情绪障碍和药物滥用。七名参与者完成了 6 个月的治疗和 6 个月的随访评估。治疗包括使用危机管理系统、个体治疗、技能培训和治疗师咨询团队。治疗后，参与者的自残行为显着减少； （Cohen's d = 1.35）、客观暴饮暴食频率（Cohen's d = .46）、清除频率（Cohen's d = .66）和全球饮食失调检查分数（Cohen's d = .64）。随访时，6 名参与者戒除 NSSI； 3 名参与者戒掉了暴饮暴食。在随访中，治疗效果得以维持并增强。结果表明，在治疗该年龄段的 BN 症状期间解决多种形式的精神病理学问题是可行的。
There are few published randomized controlled trials examining treatment for symptoms of bulimia nervosa (BN) in adolescents. Additionally, many adolescents presenting for treatment for BN symptoms endorse co-occurring mood disturbances, suicidality, and nonsuicidal self-injury (NSSI), and may not meet full Diagnostic and Statistical Manual-IV-Text Revision (DSM-IV-TR) diagnostic criteria for BN. In addition to the limited number of randomized controlled trials, published treatment studies of BN symptoms in adolescence do not specifically address the multiple comorbid symptoms that these adolescents often report. The purpose of this pilot study was to examine the feasibility and effectiveness of an outpatient dialectical behavior therapy (DBT) program for adolescents with symptoms of BN, suicide attempts, and NSSI. Ten eligible participants enrolled in the study; 3 dropped within 4 weeks of initiating treatment. In addition to binge eating and suicidal behavior, participants also endorsed a number of other comorbid mood disorders and substance abuse. Seven participants completed 6 months of treatment and 6-month follow-up assessments. Treatment included access to a crisis management system, individual therapy, skills training, and a therapist consultation team. At posttreatment, participants had significantly reduced self-harm; (Cohen's d = 1.35), frequency of objective binge episodes (Cohen's d = .46), frequency of purging (Cohen's d = .66), and Global Eating Disorder Examination scores (Cohen's d = .64). At follow-up, 6 participants were abstinent of NSSI; 3 participants were abstinent from binge eating. At follow-up, treatment gains were maintained and enhanced. Results indicate that it is feasible to address multiple forms of psychopathology during the treatment of BN symptoms in this age-group.