Dialectical Behavior Therapy Outcomes for Suicidal Adolescents and Young Adults with Internalizing and Externalizing Symptoms

Abstract

Objective:

Dialectical Behavior Therapy (DBT) is regarded as a highly effective treatment for suicide, yet no study to date has examined how DBT can help suicidal individuals with co-occurring internalizing and externalizing symptoms. Our study aimed to investigate DBT outcomes in suicidal youth and young adults with varying levels of internalizing and externalizing symptoms and the potential effectiveness of a DBT partial hospital program (PHP) on this population.

Method:

Data come from 117 adolescents and young adults (M_age = 17.82; 66% cisgender female; 83% White) who participated in a short-term, intensive DBT PHP. Regression-based moderation analyses with simple slopes assessed associations between self-reported suicidality, internalizing and externalizing symptoms, and DBT PHP outcomes: mindfulness, emotion regulation, dysfunctional coping, interpersonal competence, and DBT skills use.

Results:

Suicidal youth with clinically significant externalizing behaviors had high levels of emotion dysregulation after four weeks of treatment; however, these patients improved across all DBT outcomes, having the greatest gains in interpersonal competence and DBT skills use. All patients demonstrated improvements across DBT target outcomes, regardless of symptom type and severity.

Conclusion:

Overall, findings support DBT as an effective transdiagnostic intervention. Clinicians should strive to prioritize and allocate particular clinical attention to emotion regulation skills for patients with acute externalizing presentations to foster more effective acquisition and generalization of emotion regulation skills.