Abstract
Purpose
Rates of adolescents with Autism Spectrum Disorder (ASD) and suicidality have increased. Dialectical Behavioral Therapy (DBT) historically has been found to be effective in targeting suicide risk across the lifespan. Adolescents presenting with parent-reported autism traits were compared to those with low traits on DBT outcomes and suicidality in this study. Moreover, therapeutic alliance was also examined.
Methods
Eighty-seven adolescents attended a 4-week DBT partial hospital program (PHP); parent-report was administered to assess ASD traits. Adolescents completed self-report questionnaires at admission and discharge on four DBT outcomes. Suicidality characteristics were examined through a structured interview.
Results
We found that adolescents presenting with autism traits did not significantly differ from adolescents presenting with low or no autism traits on suicide ideation, suicide gestures, and self-harm. They did, however, significantly report fewer suicide plans and attempts. Across the sample, DBT was most effective in improving most of adolescents’ outcome skills, and this did not significantly differ based on autism traits. We also found that therapeutic alliance ratings were significantly and positively associated with the improvement outcomes observed across this sample.
Conclusion
Overall, this research supports DBT use for adolescents presenting with autism traits and emotion dysregulation.
Plain Language Summary
Why was this study done? Co-occurring Autism Spectrum Disorders (ASD) and suicidality in adolescents is important to study. This study attempts to understand this relationship and examine whether a treatment that has been helpful for suicidality and difficult to manage emotions – Dialectical Behavioral Therapy (DBT) – is helpful for adolescents presenting with and without ASD symptoms. What did the researchers do? The research team administered questionnaires to adolescents presenting at a Partial Hospital setting before and after receiving 4-weeks of DBT. Questionnaires and clinical interviews focused on ASD symptoms, suicidality, and DBT outcomes: emotion and social difficulties, mindfulness, and crisis tolerance. What did the researchers find? The total 87 adolescents in this study improved in DBT outcomes after receiving treatment, regardless of ASD symptoms. Adolescents with higher ASD symptoms, however, reported less suicide plans and attempts and continued to endorse difficulties with their therapeutic alliance. This information can help identify treatment targets for adolescents with co-occurring ASD symptoms and suicidality.
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