Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis
Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis
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DOI：
10.1016/j.beth.2018.03.009
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发表时间：
2019-01-01
期刊：
影响因子：
3.7
通讯作者：
Landes, Sara J.
中科院分区：
文献类型：
--
作者：
DeCou, Christopher R.;Comtois, Katherine Anne;Landes, Sara J.
辩证行为疗法（Dialectical Behavior Therapy，DBT）优先考虑自杀行为和其他自我导向的暴力行为作为主要治疗目标，并已在临床试验中证明可减少自我导向的暴力行为。本文综合了对照试验的结果，这些试验评估了自我导向的暴力和自杀倾向，包括自杀企图、非自杀性自伤（NSSI）、自杀意念和获得精神危机服务。确定了18项DBT对照试验。随机效应荟萃分析表明，DBT减少了自我导向的暴力（d=-.324，95%CI =-.471至-.176），并减少了精神危机服务的频率（d=-.379，95%CI =-.581至-.176）。在自杀意念方面，DBT没有显著的合并效应（d=-0.229，95%CI =-0.473至0.016）。我们的研究结果可能反映了DBT中行为优先于思想的优先顺序，并为临床实践和未来关于实施DBT治疗急性自杀倾向的研究提供了启示。
Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d=-.324, 95% CI=-.471 to -.176), and reduced frequency of psychiatric crisis services (d=-.379, 95% CI=-.581 to -.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d=-.229, 95% CI=-.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.