Dialectical Behavior Therapy for Adolescent Binge Eating, Purging, Suicidal Behavior, and Non-Suicidal Self-injury: A Pilot Study

被引:42
作者
Fischer, Sarah [1 ]
Peterson, Claire [2 ]
机构
[1] George Mason Univ, Dept Psychol, Fairfax, VA 22030 USA
[2] Univ Georgia, Dept Psychol, Athens, GA 30602 USA
关键词
bulimia; suicide; treatment; adolescent; dialectical behavior therapy; BORDERLINE PERSONALITY-DISORDER; RANDOMIZED CONTROLLED-TRIAL; BULIMIA-NERVOSA PATIENTS; FAMILY-BASED TREATMENT; CLINICAL-TRIAL; RISK-FACTORS; COMORBIDITY; RELIABILITY; VALIDATION; INVENTORY;
D O I
10.1037/a0036065
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
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.
引用
收藏
页码:78 / 92
页数:15
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