Multi-dimensional Evaluation Of The Effect Of Dialectical Behavior Therapy Oh Psychological Problems Of Adolescents With Non-suicidal Self-injury Behavior

Objective:To evaluate the intervention effect of dialectical behavior therapy(DBT)on the psychological problems of adolescents with non-suicidal self-injury(NSSI),and to explore DBT treatment programs suitable for Chinese cultural background,in order to provide some empirical evidence for the promotion of DBT in China.Methods:A total of 42 outpatients who met the NSSI diagnosis of DSM-5 in our hospital from July 2019 to September 2019 were randomly divided into experimental group(n1=21)and control group(n2=21).The experimental group received DBT-ST group psychotherapy for 13 weeks,once a week,each time 100min,while the control group received the same frequency of group supportive psychotherapy(SGT).Both groups intervened according to the unified location and theme.The intervention effect was evaluated with Ottawa Self-injury Questionnaire(OSI),Simple Self-Injury Behavior Questionnaire,Difficulties in Emotion Regulation Scale(DERS),Cognitive Emotion Regulation Questionnaire(CERQ),Barratt Impulsiveness Scale(BIS-11),Coping Style Questionnaire(CSQ)and Hamilton Depression Scale(HAMD)before intervention(baseline period),at the end of 13-weeks of intervention(13 weeks)and one-year follow-up.SPSS25.0 was used for descriptive statistics,t-est and other data analysis.Results:(1)Because 3 subjects refused to join for other reasons before the start of the trial,a total of 39 adolescents(34 females[87.18%],with an average age of(15.85±1.84))were studied.The average age of onset was(12.46±2.71),the most common site of self-injury was the upper limb,and the most common way of self-injury was cutting.(2)During the baseline period,there was no significant difference in the frequency of NSSI between the test group and the control group(P>0.05).At the end of 13 weeks of intervention,the number of participants with NSSI behaviors decreased compared with the baseline period,which was significant(P<0.05),and the treatment effect persisted at one-year follow-up.(3)At baseline,at the end of 13-weeks of intervention,one-year follow-up,there was no significant difference in the total score and its subscales of DERS between DBT-ST group and SGT group(P>0.05),after one-year follow-up,the total score of DERS in the experimental group was significantly lower than that in the baseline period,and the difference was statistically significant(P<0.05),while there was no significant change in the control group.After intervention,the score of positive emotion regulation strategy in DBT-ST group increased compared with before intervention,and the difference was statistically significant(P<0.05),the difference in the control group was not statistically significant.There was no significant difference in the total score of BIS-11 and the scores of three subscales between the two groups in the baseline period.At the end of 13 weeks of intervention and after 1 year of follow-up,the DBT-ST group scored lower unplanned impulsive factors than the SGT group,with significant differences(P<0.05).At the end of 13-weeks of intervention and one-year follow-up,the difference of BIS-11 score of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).There was no statistical significance in HAMD scores between the two groups at baseline,and no statistical significance in HAMD scores between the two groups at the end of 13-weeks of intervention and the one-year follow-up(P>0.05).At the end of 13-weeks of intervention and one-year follow-up,the total HAMD score of the two groups was significantly lower than that of the baseline period,and the difference was statistically significant(P<0.01).Conclusion:(1)In adolescent patients with NSSI,the most common way of self-injury is to cutting,hitting and stabbing the skin with sharp objects,and the common site of self-injury is the upper limb.(2)Both DBT-ST and SGT can reduce the NSSI behavior of adolescents,but because of the small sample size,there is no significant statistical significance between the two treatments,and subsequent studies need to expand the sample size to verify.(3)Both DBT-ST and SGT could improve the cognitive and coping strategies,DBT-ST outperformed SGT in impulsive and psychological problems(especially impulse and strategy factors)in adolescents with NSSI.(4)Both DBT-ST and SGT improved the depression of adolescents with NSSI.